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MARK LEE PEMBERTON PAC
NPI 1669433652
Physician Assistant - Surgical in Shawnee Mission, KS

Active since March 29, 2006PECOS Enrolled
7450 KESSLER ST STE 202, SHAWNEE MISSION, KS 66204(913) 632-9480(913) 632-9499 Get Directions Write a Review

NPPES record last updated: March 20, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 20, 2025, Jul 21, 2022, Aug 16, 2017 (3 updates tracked since 2017).

About Mark Lee Pemberton Pac NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARK LEE PEMBERTON PAC (NPI 1669433652) is an individual surgical provider in Shawnee Mission, Kansas, licensed in Kansas (1500212) and active in the NPI registry since March 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1669433652
Entity TypeIndividualMale
Primary Taxonomy363AS0400X
Provider Legal NameMARK LEE PEMBERTONCredential: PAC
Location Address7450 KESSLER ST STE 202Shawnee Mission, KS 66204-2553
Mailing Address7450 Kessler St Ste 202Shawnee Mission, KS 66204-2553 · (913) 632-9480 · Fax (913) 632-9499
Phone(913) 632-9480
Fax(913) 632-9499
Sole ProprietorNo
Enumeration DateMarch 29, 2006
Last NPPES UpdateMarch 20, 20253 updates tracked since enumeration
NPPES CertifiedMarch 20, 2025
✔ NPI 1669433652 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
License✔ Licensed in KS · 1500212
7450 KESSLER ST STE 202, Shawnee Mission, KS 66204
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter from Sunflower Health Plan, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mark Lee Pemberton Pac is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
30 services30 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
29 services28 patients
Partial removal of spine bone with release of lower spinal cord and/or nerves, 1 segment 63047
This procedure involves removing part of a spine bone to alleviate pressure on the lower spinal cord and/or nerves. It targets a single segment of the spine, improving mobility and reducing pain. It's a common treatment for conditions like herniated discs or spinal stenosis.
11 services11 patients

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

REBECCA ANDREWS APRN FNP-C
Nurse Practitioner
7450 KESSLER ST STE 202
MERRIAM, KS 66204
Johnson County (913) 632-9480
MR. IAN MCCOMBS
Nurse Practitioner
7450 KESSLER ST STE 202
MERRIAM, KS 66204
Johnson County (913) 632-9480
DAVID VAUGHN PORTER JR. PA-C
Physician Assistant (Medical)
7450 KESSLER ST STE 202
MERRIAM, KS 66204
Johnson County (913) 632-9480
DR. MATTHEW PIERSON M.D.
Neurological Surgery
7450 KESSLER ST STE 202
MERRIAM, KS 66204
Johnson County (913) 632-9480
DR. JAYSON NEIL M.D.
Neurological Surgery
7450 KESSLER ST STE 202
SHAWNEE MISSION, KS 66204
Johnson County (913) 632-9480
DR. DANIELLE MARIE SUTTON DNP-APRN
Nurse Practitioner (Adult Health)
7450 KESSLER ST STE 202
MERRIAM, KS 66204
Johnson County (913) 632-9480
DR. DARREN S LOVICK MD
Neurological Surgery
7450 KESSLER ST STE 202
SHAWNEE MISSION, KS 66204
Johnson County (913) 632-9480
VERONICA M GAVULA PA-C
Physician Assistant
7450 KESSLER ST STE 202
MERRIAM, KS 66204
Johnson County (913) 632-9480

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mark Pemberton's NPI number?

The NPI number for Mark Pemberton is 1669433652. It was assigned to this individual provider in the NPPES registry on March 29, 2006.

Where is Mark Pemberton located?

Mark Pemberton practices at 7450 Kessler St Ste 202, Shawnee Mission, KS 66204. The listed phone number is (913) 632-9480.

What is Mark Pemberton's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Is Mark Pemberton enrolled in Medicare?

Yes. Mark Pemberton is registered in the Medicare PECOS enrollment system.

What insurance does Mark Pemberton accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Home State Health, Ambetter from Sunflower Health Plan and Ambetter of Oklahoma list Mark Pemberton as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Mark Pemberton was last updated on March 20, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.